MUSTANSIRIA DENTAL JOURNAL

Aim of the study: to evaluate the effect of probiotics on gingival health and levels of IL-6 in saliva. Measuring levels of IL-6 in different intervals at zero time before taking probiotic lozenges, 14 days after daily intake of probiotics, and after 28 days of daily intake of probiotics with measuring the gingival index (GI) for children. Material and method: A prospective study was conducted from 18, November 2023 to 18, December 2023, involving 100 children (49 females and 51 males) aged 10 years in Anbar, Iraq. Saliva samples were collected at baseline (day 0), day 14, and day 28 after taking probiotic lozenges to measure cytokine levels (IL-6) using ELISA assays. Gingival health was assessed using the Gingival Index. Results: The period at 28 days for Gingival Index (GI) recorded the lowest mean±SD, at 0.517 ±0.23, closely followed by the highest record at the baseline period (day 0) with a mean±SD of 1.51 ±0.18. In contrast, the period at 14 days showed mean±SD, at 0.94 ±0.26. Statistical analysis indicated a significant differences among these periods (p-value < 0.05).

The results for IL-6 levels indicated that the 14-day group exhibited the highest mean±SD, at 0.55±0.15. This was followed by the 28-day group, which showed a mean±SD of 0.52±0.11. In contrast, the baseline group (day 0) had the lowest mean±SD, at 0.48±0.12. Conclusion: The study demonstrated significant improvements in gingival health with probiotic lozenge use over 28 days. There was a marked reduction in the Gingival Index, indicating decreased gingivitis severity, from moderate gingivitis (at baseline) to mild gingivitis (after 28 days). The IL-6 levels peaked at 14 days, suggesting an initial immune response, and then slightly decreased by 28 days, reflecting an adaptation to probiotic treatment.

Aims: The purpose of this research was to evaluate the knowledge and awareness of undergraduate medical and dental students from various Iraqi universities regarding oral cancer. Methods: A cross-sectional survey was conducted, and questionnaires were distributed to 378 students. Awareness and knowledge of oral cancer were assessed through questions related to examinations, patient history, risk factors for oral cancer, and the clinical appearance of oral cancer.
Results: Dental participants reported significantly higher percentages (84.8%) for routine oral examinations compared to medical students (50.4%). Smoking was identified as a risk factor by 90.8% of medical students and 77.0% of dental students. A very small percentage of both dental (9.7%) and medical (5.0%) students felt they were very well informed about the clinical appearance of oral cancer. Regarding oral changes associated with oral cancer, 70.6% of medical students and 56.8% of dental students recognized leukoplakia. The majority of medical (91.6%) and dental (94.9%) students indicated that they needed more information about oral cancer.
Conclusions This study identified both strengths and weaknesses in oral cancer knowledge among dental and medical students. While dental students displayed greater awareness in certain areas, the overall findings emphasize the need for ongoing education and training.

Background: Knowledge of root canal morphology is essential for performing a successful RCT that includes proper mechanical and chemical debridement, as well as effective root canal filling. Failing to clean and shape all root canals can result in treatment failure due to persistent infection from microorganisms left in the untreated canal.
Aim of the study: To evaluate the presence of a 2nd root in the lower canine or a single root with two canals in the mandibular canine via CBCT.
Material and methods: A total of 316 patients visited our clinic in Baghdad, Iraq, for various treatment modalities. After CBCT imaging to analyse the morphology of the permanent mandibular canine on each side, data were collected and cases with any side of the canine being absent, incomplete root formation, root canal-treated teeth, teeth with periapical pathology, or any internal or external tooth resorption were excluded.
Results: Double-rooted mandibular canines were observed in 32 out of 632 cases (5%). A bilateral examination revealed 8 cases with bilateral double-rooted mandibular canines, while the others exhibited these on the left side only. Variable root canal configuration occurred in 36 cases (5.6%). Significant differences in data were observed between men and women.
Conclusions: Most people’s mandibular canines have one canal in single root according to the CBCT examination. All double-rooted mandibular canines occurred in women and most of these were found on the left side. Additionally, mandibular canines with two canals in one root were more frequently observed in women than in men.

Background: Patients with tooth misalignment are typically treated with traditional brackets during orthodontic treatment. The complexity of bracket design often hinders proper oral hygiene, resulting in an increased load of microbiota. The shape of the brackets acts as a reservoir for Candida, leading to candidosis of the oral cavity.
Aims: This investigation aims to evaluate the impact of fixed orthodontic appliances on the count and distribution of salivary Candida species compared to saliva from subjects without orthodontic appliances. Methods: Eightyparticipants from the Iraqi population wearing fixed orthodontic devices comprised the study group, while 20 participants without orthodontic devices served as the control group. Salivary samples were obtained from both groups, and Candida chromogenic agar was used for cultivation. The counting and identification of different Candida species were confirmed using the Vitek 2 system to validate cultural characteristics.

Results: In this study, four types of Candida species were identified: C.parapsilosis, C.albicans, C. tropicalis & C.krusei in comparison to various published researchs, this study showed no statistically significant increase in colonization by any Candida species colonization during the orthodontic treatment. However, C. tropicalis was the most frequently isolated species for both test and control groups in comparison with other species. The fixed appliances had no impact on the existence, non-attendance or scale of habitation by Candida species and there were no considerable variation in the prevalence of Candida species, based on different factors (age, gender, and saliva pH) for both test and control groups.
Conclusions: The results of this study indicate that fixed orthodontic treatment had no effect on the prevalence of Candida species. This suggests that Candida accumulation may be related to an individual's own oral flora and is influenced by oral hygiene practices throughout their life.
Key words: Candida albicans, C. tropicalis, C. glabrata, C. parapsilosis, C.krusei, fix orthodontic appliance.

Aim: The current study aimed to determine the effects of chronic myeloid leukemia on oral health status and the presence of oral lesions in a group of Iraqi patients compared to healthy controls. Materials and Methods: The total sample consisted of 60 individuals, (30) were diagnosed with CML and (30) were healthy controls. Clinical examinations were carried out according to WHO oral health surveys. The scoring of dental plaque was according to plaque index criteria of Silness and Löe (1964), dental calculus was scored using Ramfjord's calculus index criteria (1959), the scoring of gingival status was according to gingival index criteria of Loe and Silness (1963), probing pocket depth and clinical attachment loss were scored according to WHO oral health survey (2013) and oral lesions examination was including inspection of intra-oral soft tissues. A mouth mirror and CPI probe were used in clinical examinations. Results: The plaque index was higher in CML group than the control group with statistically significant difference between the two groups (p<0.05). Gingival index, probing pocket depth, and clinical attachment loss were higher in the CML group as compared to healthy individuals and the difference was highly significant between two groups (p≤0.01). Although the calculus index was higher in the CML group, the difference was not statistically significant (p>0.05). Conclusion: Patients with chronic myeloid leukemia presented inferior oral health and higher susceptibility for oral lesions compared to healthy individuals.Conclusion: Patients with chronic myeloid leukemia exhibited worse oral health conditions and more oral lesions compared to healthy individuals.

Background: The aim of this review is to identify, evaluate, and analyze the methodologies used for the quantitative assessment of root canal transportation. Numerous research papers have examined various transportation methods employed across different instrumentation approaches. A range of experimental models, utilizing simulated canals or extracted teeth provide valuable illustrations of the significance of root canal transportation. However, studies have utilized several approaches for quantitatively evaluating root canal movement, which poses challenges in comparing the results. In this study, a comprehensive literature review was conducted by searching databases such as PubMed, Google Scholar, and Scopus, as well as examining the reference lists of relevant papers. The search was carried out up to the year 2023, using relevant keywords to identify various methodologies employed in the evaluation of root canal transportation.

Results: The methods used in the selected papers were gathered, evaluated, and categorized. Scientific studies typically follow a standardized structure that encompasses three fundamental stages: image capture, measurement of images, and computation of parameters.
Conclusion:It is concluded that in future research concerning root canal transportation, a full evaluation of the root canal's length be performed using a 3D imaging technique is recommended. This method would necessitate measuring the distance from the center point for each segment, despite its inherent drawbacks of being laborious and expensive.

Background: Dental implant surface characteristics affect the success of implant treatment. Many studies have focused on coating titanium (Ti) implant surfaces with bioactive materials. Bio-active surfaces play a crucial role in enhancing the healing process of the human bone tissue surrounding dental implants.
Aims of the research: This study aims to evaluate the histological response and bonding strength of titanium screws coated with a combination of nano-sized titanium oxide (TiO₂) and nano-hydroxyapatite (HA) after healing intervals of two and six weeks.
Materials and methods: A suspension was prepared using 5.27 g of nano-hydroxyapatite and 2.68 g of nano-titanium oxide. Commercially pure Grade II titanium screws, measuring 3.0 mm in diameter and 8 mm in length, were coated using the dip-coating technique. The presence of the nano-coating on the titanium surfaces was confirmed through X-ray diffraction (XRD) and microscopic analysis. For histological evaluation, some screws were coated with the nano TiO₂–HA mixture, while others were coated solely with nano-HA, and both types were implanted into the tibiae of New Zealand rabbits. Peri-implant bone formation was analyzed at two and six weeks post-implantation using a light microscope equipped with a GT-N7100 camera.
Results: Optical microscopy revealed a uniform, crack-free coating layer on the titanium screw surfaces. XRD patterns confirmed the presence of both hydroxyapatite and titanium dioxide phases. Histological analysis showed enhanced new bone formation in the group with the TiO₂–HA mixture coating, evidenced by early osteoblast proliferation and more advanced bone maturation at both two and six weeks post-surgery, when compared to implants coated only with nano-hydroxyapatite.
Conclusion: The implant coating mixture of nano TiO2 & nano HA promotes new bone formation more rapidly than a coating of nano hydroxyapatite alone.

Aim of the study: The purpose of this in vitro investigation was to compare the impact of different fibers on the fracture resistance of maxillary first premolar teeth with MOD cavities.

Materials and methods: Sixty sound, non-carious human maxillary first premolars were selected for this study and randomly divided into four groups (n = 15). Groups A, B, and C consisted of intact teeth utilized as the control group, teeth restored with ribbond, and teeth restored with composite (Palfique LX5, Tokuyama, Japan) respectively. Group D included dental restorations using SFRC Ever X Posterior (GC, Japan). The occlusal surface of each tooth was imprinted using flowable composite material (stamp technique), and all teeth were mounted in a 2cm² square block of self-curing acrylic resin. A large class II MOD cavity preparation was performed for all groups except for Group A. The dimensions of the cavities were standardized as follows: the occlusal depth was 3 mm, the occlusal width buccolingually was 2/3 of the intercuspal distance, and the MO and DO boxes were prepared with a height of 1.5 mm at their axial walls. The teeth were tested in a universal testing apparatus with a 0.5 mm/min compressive load rate till fractures take until fractures occurred.
The analysis of variance (ANOVA) and Tukey’s (HSD) tests were used to determine the statistical significance of the variation in fracture resistance among the groups under investigation, using a significance level of 0.05.

Results: The results revealed that the groups restored with fibers (Group B and Group D) exhibited greater fracture resistance than group restored with composite only (Group C).

Conclusions: In the context of the present investigation, teeth restored with Ribbond insertion demonstrated a significant increase in fracture resistance compared to the other tested groups, followed by teeth restored with Ever X posterior. In contrast, teeth restored with Tokuyama Palfique LX5 composite without fibers exhibited the least fracture resistance.

The purpose of this study is to contrast the salivary levels of C-reactive protein between healthy controls and diabetic patients at various stages of periodontitis.
Materials and methods: One hundred sixty men participated in this study; 32 of them were healthy control groups, while the other 128 men with type -2 diabetes were equally categorized into four groups according to stages of periodontitis (stage I, stage II, stage III, and stage IV). Following the collection of unstimulated salivary samples from each participant, (PPD, CAL, and BOP) clinical periodontal parameters were assessed. ELISA technique was used to measure the levels of CRP in saliva samples. Results: CRP was higher in diabetic patients with all stages of periodontitis than healthy controls. The level of CRP is increased when periodontitis progresses to higher stages. Stage IV group (515.33±258.51), stage III group (315.52±206.71), stage II group (206.61±124.64), stage I (160.07±97.49), control group (45.63±25.29) in which their salivary levels were the least with significant differences among the groups (p=0.000).
Conclusion: The inflammatory marker CRP is increased in diabetic patients than in Control, especially when the stage of periodontitis gets worse.

Background: Dental caries is a common disease among humans, and its significant impact underscores the need to promote the mineralization of early enamel lesions. Numerous materials have been investigated to enhance the mineralization of teeth. Casein phosphopeptides-amorphous calcium phosphate (CPP-ACP), a milk protein known for its effectiveness in mineralization of tooth.
Aim of study: To assess CPP-ACP’s effect on the enamel microhardness of teeth treated with 5% sodium fluoride.
Materials and Method: Forty extracted sound upper first premolars were utilized in the study. The teeth underwent a pH cycle, after which, 20 teeth were treated with a 5% sodium fluoride solution (NaF), while the remaining 20 to deionized water. All teeth were placed in artificial saliva for 24 hours and subsequently treated with 10% CPP-ACP for seven days. Enamel microhardness was evaluated before and after the artificial formation of caries-like lesions, following the application of 5% sodium fluoride and deionized water, and after the application of CPP-ACP on the previously treated groups.
Results: It was found that 5% NaF significantly elevated the microhardness of the enamel after demineralization (P=0.000), the mean microhardness value post-demineralization was (119.11), while post-remineralization was (195.910) and following the application of CPP-ACP it became (226.100) which was also significant (P=0.025).
Conclusion: CPP-ACP is an effective material for mineralizing early carious lesions alone, but it performs its best effect when combined with NaF.

Aim: This study examined the cytotoxic effects of Nano Polyvinylidene-Fluoride (PVDF) on Human Gingival Fibroblasts (HGF) cells in comparison to sodium fluoride (NaF) varnish.
Method: The MTT-Assay was performed to evaluate the cytotoxicity of the tested materials on HGFs. To assess the toxic effects, cell viability after the application of NaF varnish (2.26%) and PVDF (1.26%, 2.26%, and 3.26%) at each concentration.
Results: The findings indicated that all concentrations of PVDF exhibited lower cytotoxicity compared to NaF varnish. Within the PVDF groups, the 3.26% concentration demonstrated the least cytotoxicity, succeeded by 2.26% and 1.26% respectively. On the other hand, NaF varnish exhibited the greatest toxicity among the evaluated substances.


Conclusion: This innovative study demonstrates that Nano-PVDF, particularly at a concentration of 3.26%, is a promising material exhibiting enhanced biocompatibility and less cytotoxicity relative to traditional NaF varnish. All data represented that Nano-PVDF may function as a safer option in dental treatments, with exhibiting little adverse effects on oral cells.

Aim: to compare the marginal fitness of zirconia crowns made using laboratory scanners and various cone beam computed tomography (CBCT) parameter.
Methods: An extracted premolar tooth was prepared for a crown by zirconia crown preparation criteria. The scanning of the prepared tooth using Medit T710 extraoral scanner (group A), and CBCT scans were made with (planmeca promax) CBCT at different setting parameters: (group B) with the field of view 80x50mm and 150um voxel size and (group C) in which tooth scanned by another CBCT parameters with a field of view 50x50 mm and 75um voxel size. The 3D pictures from the CBCT scans and laboratory scanner were then imported into Exocad software, and a crown design was finished. The crowns are milled from computer-aided design/computer-aided manufacturing CAD/CAM zirconia by a 5-axis milling machine. A stereo-zoom microscope was used to assess the vertical marginal gap. A total of 120 points were measured throughout three groups (4 sites per crown). Vertical marginal gap mean values were obtained by averaging the readings for each specimen. The data was analysed using one-way ANOVA, and the Post hoc Tukey's test was performed to compare the significance of the difference between groups.


Result: one-way ANOVA indicated that there was a significant difference in marginal gaps among the experimented groups (p-value = 0.001). The results of the Post hoc HSD Tukey's test showed that there was no significant difference between the laboratory scanner (group A) and CBCT scan (group C) with the field of view (FOV) 50x50mm and 75um voxel size (p value=0.052). However, there was a significant difference between the laboratory scanner and CBCT scan group with (FOV) 80x50mm and 150um voxel size (group B), and also between CBCT scan groups (B and C) with different parameters(p-value=0.001).
Conclusion: Crowns made with the laboratory scanner exhibited smaller marginal gaps than crowns made using CBCT images with various settings parameters. All three groups were able to fabricate monolithic zirconia crowns with a marginal gap of less than 120um.